Pediatric emergency care
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Pediatric emergency care · Jun 2010
Case ReportsSpinal cord injury from spontaneous epidural hematoma: report of 2 cases.
Two cases of acute spinal cord injury resulting from spontaneous spinal epidural hematoma are reported, both of which had a cavernous vascular malformation origin. Both spontaneous spinal epidural hematoma and intramedullary cavernous malformation are rare in children. In the pediatric emergency setting, spontaneous epidural hematoma should be considered as part of the differential diagnosis for acute extremity weakness and paresthesia. Immediate magnetic resonance imaging of the brain and spine as well as prompt neurosurgical consult is recommended for the best chance of improved outcome.
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Pediatric emergency care · Jun 2010
Case ReportsRapidly developing gas gangrene due to a simple puncture wound.
Gas gangrene, an infection caused by Clostridium perfringens, is a potentially fatal and physically disabling disease due to its sometimes incredibly rapid progression. An adolescent boy was referred to our university hospital with a history of nail puncture in the hand that occurred a few hours previously. The physical examination revealed a swollen and tender arm with crepitations up to the shoulder. ⋯ Having received 1 dose of meropenem, the boy had surgery, in which his entire upper extremity had to be disarticulated from the shoulder. The maintenance antimicrobial therapy with intravenously administered penicillin G and clindamycin was continued for a duration of 10 days, at the end of which, the patient was discharged. The rapidly progressive character and the dramatic ending of this case made us wonder whether antimicrobial prophylaxis would play any role in the preventive management of puncture wounds.
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Pediatric emergency care · Jun 2010
A pilot study to assess candidacy for emergency contraception and interest in sexual health education in a pediatric emergency department population.
The objective of the study was to assess potential candidacy for hormonal emergency contraception (EC) and desire for sexual health education among female adolescents presenting for care to a pediatric emergency department (ED). ⋯ Among sexually active adolescents seeking care in an urban, children's hospital ED, a significant proportion could potentially utilize EC if they so chose. Furthermore, adolescents with and without a history of sexual activity expressed interest in learning about sexual health issues in the ED setting.
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Pediatric emergency care · Jun 2010
Off-label and unlicensed medication use and associated adverse drug events in a pediatric emergency department.
The study objectives were to (1) determine the types and frequency of off-label (OL) or unlicensed (UL) medications used in a pediatric emergency department (PED) and before admission, (2) describe OL/UL-associated adverse drug events (ADEs) resulting in admission to the PED and those occurring during patient care in PED, and (3) determine the outcomes of these ADEs. ⋯ The frequency of reported ADEs associated with OL/UL medications was less than the frequency of ADEs from licensed medication use, with overall ADE frequency of less than 1%.
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Pediatric emergency care · Jun 2010
Case ReportsRetropharyngeal abscess in a young child due to ingestion of eel vertebrae.
Foreign body ingestion was immediately suspected at the emergency department when a 14-month-old boy presented with fever, refusal to eat, and history of choking after consumption of congee with minced fish meat the day before. Two eel vertebrae were subsequently retrieved from the piriform fossa. This case is reported to discuss the importance of obtaining the relevant history of foreign body ingestion and high index of suspicion in very young children. Parents must be educated about the risk of feeding infant and young children with bone-containing foods.